Octa-based detection of retinal microvascular alterations in jia patients without ocular involvement: unveiling subclinical manifestations

Purpose: This study evaluates retinal microvascular alterations in Juvenile Idiopathic Arthritis (JIA) patients without uveitis using Optical Coherence Tomography Angiography (OCTA) and compares findings with healthy controls. Methods:A cross-sectional study included 42 JIA patients without uveitis and 48 age-and sex-matched controls.OCTA assessed superficial and deep capillary plexus vessel density, peripapillary retinal nerve fiber layer (PPRNFL) thickness, radial peripapillary capillary vessel density (RPC-VD), and foveal avascular zone (FAZ) area.Statistical analyses included independent samples t-test and Mann-Whitney U test for group comparisons.Results: JIA patients showed reduced foveal vessel density in the superficial (20.33 6.46% vs. 24.63 6.46%, p = 0.003) and deep plexuses (37.00 5.70% vs. 41.41 5.70%, p = 0.002).PPRNFL thickness (120.62 15.44 m vs. 110.77 15.44 m, p = 0.001) and RPC-VD (51.76 3.05% vs. 49.85 3.05%, p = 0.002) were elevated.FAZ area showed a non-significant trend toward enlargement (p = 0.102).Multivariate regression confirmed these findings were independent of age, sex, and disease duration. Conclusion:OCTA reveals subclinical retinal microvascular changes in JIA, suggesting early inflammatory effects.These findings support OCTA as a non-invasive tool for detecting vascular involvement, though a multimodal approach is recommended.Longitudinal studies are needed to assess progression and its clinical impact.